Heart POCUS Mastery: Can Anyone Unlock the Skill?

Cardiologists routinely perform echocardiography. Should point of care ultrasound of the heart also be utilized by non-cardiologists?

Numerous articles in PubMed and other databases advocate for non-cardiologists to utilize heart ultrasound. The combination of ultrasound with clinical expertise can expedite clarification, validate or challenge diagnoses, and facilitate swifter implementation of interventions (1).

In Levanger Hospital in Norway, a targeted examination of patients admitted to the medical department, conducted by a skilled ultrasound doctor, showcased diagnostic utility in nearly half of all patients examined. Almost one in five experienced a change in diagnosis (2).

This underpins the belief that point of care ultrasound of the heart can assist clinicians in their daily practice. Specifically, the synergy between clinical evaluation and ultrasound findings can be pivotal for a patient's prognosis. What if you encounter an impending cardiac tamponade requiring urgent pericardiocentesis? What if you unveil an aortic dissection with a high mortality rate? And how should you proceed if you identify right heart strain - could it be a pulmonary embolism?

Always bear in mind that your clinical judgment and the ultrasound findings you reveal can potentially be crucial for your patient!

References

1. Labovitz AJ, Noble VE, Bierig M, Goldstein SA, Jones R, Kort S, et al. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr. 2010;23(12):1225-30.
2. Mjolstad OC, Dalen H, Graven T, Kleinau JO, Salvesen O, Haugen BO. Routinely adding ultrasound examinations by pocket-sized ultrasound devices improves inpatient diagnostics in a medical department. Eur J Intern Med. 2012;23(2):185-91.